BACKGROUND: Well-differentiated hepatocellular carcinoma (HCC) may resemble benign liver lesions on initial diagnostic work-up. The validity of surgical resection for preoperatively unclear liver lesions was investigated in this study. PATIENTS AND METHODS: We conducted a retrospective analysis of 483 patients subjected to liver resection over a 15-year period. RESULTS: Forty-five patients (9%) were considered to have presented with indeterminate solitary lesions. There were 18 cases of HCC (40%) and 27 cases (60%) of benign lesions, most commonly focal nodular hyperplasia (n=18). Patients with HCC had a higher median age as compared to patients with benign pathology (67 vs. 55 years; p=0.002) and the median tumor size was larger (85 vs. 30 mm; p=0.007). Major complications (Clavien grade III or higher) occurred in three cases (7%) and there was no in-hospital mortality. CONCLUSION: The results favor an aggressive approach, i.e. surgical intervention, to patients presenting with indeterminate solitary liver tumors due to the high likelihood of an underlying HCC.
BACKGROUND: Well-differentiated hepatocellular carcinoma (HCC) may resemble benign liver lesions on initial diagnostic work-up. The validity of surgical resection for preoperatively unclear liver lesions was investigated in this study. PATIENTS AND METHODS: We conducted a retrospective analysis of 483 patients subjected to liver resection over a 15-year period. RESULTS: Forty-five patients (9%) were considered to have presented with indeterminate solitary lesions. There were 18 cases of HCC (40%) and 27 cases (60%) of benign lesions, most commonly focal nodular hyperplasia (n=18). Patients with HCC had a higher median age as compared to patients with benign pathology (67 vs. 55 years; p=0.002) and the median tumor size was larger (85 vs. 30 mm; p=0.007). Major complications (Clavien grade III or higher) occurred in three cases (7%) and there was no in-hospital mortality. CONCLUSION: The results favor an aggressive approach, i.e. surgical intervention, to patients presenting with indeterminate solitary liver tumors due to the high likelihood of an underlying HCC.